Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials
Background: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treat...
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2025-01-01
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| Series: | Current Oncology |
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| author | Andrea Messori Andrea Ossato Lorenzo Gasperoni Luna Del Bono Alessandro Inno Vera Damuzzo |
| author_facet | Andrea Messori Andrea Ossato Lorenzo Gasperoni Luna Del Bono Alessandro Inno Vera Damuzzo |
| author_sort | Andrea Messori |
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| description | Background: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treatment options is limited. Methods: We undertook a meta-analysis that compared combination regimens with the current standard of care. Only randomized controlled trials (RCTs) were included (endpoint, overall survival [OS]). Our analysis used an artificial intelligence software program that reconstructs individual patient data from Kaplan–Meier curves. Hazard ratio (HR) with 95% confidence interval (CI) was the main parameter. Heterogeneity was based on Wald’s test and likelihood ratio test. Results: Five RCTs were included, whose experimental arms included five different combinations. In our analysis, these combination regimes showed no OS benefit compared to chemotherapy (HR = 1.066, 95%CI, 0.9311 to 1.221; <i>p</i> = 0.35). Among the five control arms, cross-trial heterogeneity was remarkably low (likelihood ratio test = 3.76 on 4 df, <i>p</i> = 0.40; Wald test = 3.83 on 4 df, <i>p</i> = 0.40. Discussion: In conclusion, five new second-line combination treatments for patients with NSCLC were not found to determine any benefit in terms of OS in comparison with the current standard of care. |
| format | Article |
| id | doaj-art-170dec5990514c5abf8fd1e58a6c2ef1 |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Current Oncology |
| spelling | doaj-art-170dec5990514c5abf8fd1e58a6c2ef12025-01-24T13:28:28ZengMDPI AGCurrent Oncology1198-00521718-77292025-01-013214610.3390/curroncol32010046Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled TrialsAndrea Messori0Andrea Ossato1Lorenzo Gasperoni2Luna Del Bono3Alessandro Inno4Vera Damuzzo5HTA Unit, Regional Health Service, 50139 Florence, ItalyDepartment of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padova, ItalyOncological Pharmacy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, ItalySchool of Specialization in Hospital Pharmacy, Department of Pharmacy, University of Pisa, 56126 Pisa, ItalyMedical Oncology, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar di Valpolicella, ItalyHospital Pharmacy, Vittorio Veneto Hospital, 31029 Vittorio Veneto, ItalyBackground: Immune checkpoint inhibitors (ICIs), either alone or in combination with platinum-based chemotherapy, are effective in the first-line treatment of metastatic, non-oncogene-addicted, non-small cell lung cancer (NSCLC). However, when NSCLC patients progress, the efficacy of available treatment options is limited. Methods: We undertook a meta-analysis that compared combination regimens with the current standard of care. Only randomized controlled trials (RCTs) were included (endpoint, overall survival [OS]). Our analysis used an artificial intelligence software program that reconstructs individual patient data from Kaplan–Meier curves. Hazard ratio (HR) with 95% confidence interval (CI) was the main parameter. Heterogeneity was based on Wald’s test and likelihood ratio test. Results: Five RCTs were included, whose experimental arms included five different combinations. In our analysis, these combination regimes showed no OS benefit compared to chemotherapy (HR = 1.066, 95%CI, 0.9311 to 1.221; <i>p</i> = 0.35). Among the five control arms, cross-trial heterogeneity was remarkably low (likelihood ratio test = 3.76 on 4 df, <i>p</i> = 0.40; Wald test = 3.83 on 4 df, <i>p</i> = 0.40. Discussion: In conclusion, five new second-line combination treatments for patients with NSCLC were not found to determine any benefit in terms of OS in comparison with the current standard of care.https://www.mdpi.com/1718-7729/32/1/46immune checkpoint inhibitorsbiomarkersresistance mechanismsnon-small cell lung cancer |
| spellingShingle | Andrea Messori Andrea Ossato Lorenzo Gasperoni Luna Del Bono Alessandro Inno Vera Damuzzo Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials Current Oncology immune checkpoint inhibitors biomarkers resistance mechanisms non-small cell lung cancer |
| title | Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials |
| title_full | Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials |
| title_fullStr | Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials |
| title_full_unstemmed | Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials |
| title_short | Treatment Options for Advanced Non-Small Cell Lung Cancer After Failure of Previous Immune Checkpoint Inhibitors and Chemotherapy: Meta-Analysis of Five Randomized Controlled Trials |
| title_sort | treatment options for advanced non small cell lung cancer after failure of previous immune checkpoint inhibitors and chemotherapy meta analysis of five randomized controlled trials |
| topic | immune checkpoint inhibitors biomarkers resistance mechanisms non-small cell lung cancer |
| url | https://www.mdpi.com/1718-7729/32/1/46 |
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